Cancer

A 45-year-old female was recently diagnosed with cervical cancer. Which of the following is the most likely cause of her cancer? A. Herpes virus B. Rubella virus C. Human papillomavirus (HPV) D. Hepatitis B virus

C

A lobectomy is scheduled for a patient with stage I non-small cell lung cancer. The patient tells the nurse, "I would rather have chemotherapy than surgery." Which response by the nurse is most appropriate? A. "Are you afraid that the surgery will be very painful?" B. "Did you have bad experiences with previous surgeries?" C. "Tell me what you know about the treatments available." D. "Surgery is the treatment of choice for stage I lung cancer."

C

A nurse is discussing preinvasive epithelial tumors of glandular or squamous cell origin. What is the nurse describing? A. Tumor in differentiation B. Dysplastic C. Cancer in situ D. Cancer beyond (meta) situ

C

A patient asks when adjuvant chemotherapy is used. How should the nurse respond? Adjuvant chemotherapy treatment is used: A. as the primary treatment. B. before radiation therapy. C. after surgical removal of a tumor. D. in cancer with little risk of metastasis.

C

A patient develops skin cancer on the head and neck following years of sunbathing. Which of the following cancers is most likely? A. Lymphoma B. Adenoma C. Basal cell carcinoma D. Leukemia

C

A nurse is giving an example of inflammation as an etiology for cancer development. What is the best example the nurse should give? A. Pneumonia and lung cancer B. Ulcerative colitis and colon cancer C. Prostatic hypertrophy and prostate cancer D. Hypercholesterolemia and leukemia

B

A nurse is reviewing assessment findings for a female patient admitted to the oncology unit. Which finding should alert the nurse to contact the physician? A. Blood pressure 130/88 B. Noticeable difference in circumference of lower legs C. Presence of goiter previously identified on prior admission D. Negative guaiac test

B

A patient asks why indoor pollution is worse than outdoor pollution. How should the nurse respond? Indoor pollution is considered worse than outdoor pollution because of cigarette smoke and: A. fireplace wood smoke. B. radon. C. benzene. D. chlorine.

B

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? A. Give the patient the prescribed PRN opioid. B. Assess for sensation and strength in the legs. C. Notify the health care provider about the symptoms. D. Teach the patient how to use relaxation to reduce pain.

B

A patient has a tissue growth that was diagnosed as cancer. Which of the following terms best describes this growth? A. Malignant tumor B. Lipoma C. Meningioma D. Hypertrophy

A

What is the effect of telomere caps on cancer cells? A. Repeated divisions B. Clonal distinction C. Limited mitosis D. Mutation abilities

A

A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the following is of concern for this patient? A. Gastric cancer B. Leukemia C. Lung cancer D. Adenocarcinoma of the colon

A

A 52-year-old male with hepatitis C recently developed hepatic cancer. Which of the following markers should be increased? A. Alpha-fetoprotein (AFP) B. Catecholamines C. Prostate-specific antigen D. Homovanillic acid

A

Which action should the nurse take when caring for a patient who is receiving chemotherapy and reports problems with concentration? A. Suggest use of a daily planner and encourage adequate sleep. B. Teach the patient to rest the brain by avoiding new activities. C. Teach that "chemo-brain" is a short-term effect of chemotherapy. D. Report patient symptoms immediately to the health care provider.

A

Brachytherapy is being used to treat cancer in a patient. What types of cancers respond well to brachytherapy? (Select all that apply.) A. Prostate B. Cervix C. Head D. Neck E. Lung

A, B, C, D

When an oncologist is teaching about how radiation induces genomic instability, which topic should the oncologist discuss? A. Increasing hypersensitivity B. Facilitating new mutations C. Promoting cell death D. Enhancing mitosis

B

A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem? A. Suggest that the patient limit social contacts until hair regrowth occurs. B. Encourage the patient to purchase a wig or hat to wear when hair loss begins. C. Teach the patient to wash hair gently with mild shampoo to minimize hair loss. D. Inform the patient that hair usually grows back once chemotherapy is complete.

B

An oncologist is discussing when a cancer cell loses differentiation. Which of the following is the oncologist describing? A. Autonomy B. Anaplasia C. Pleomorphic D. Metastasis

B

Which of the following options should the nurse incorporate into the plan of care as a primary prevention strategy for reduction of the risk for cancer? A. Yearly mammography for women aged 40 years and older B. Using skin protection during sun exposure while at the beach C. Colonoscopy at age 50 and every 10 years as follow-up D. Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over

B

The nurse should suggest which food choice for a patient scheduled to receive external-beam radiation for abdominal cancer? A. Fruit salad B. Baked chicken C. Creamed broccoli D. Toasted wheat bread

B Protein is needed for wound healing. To minimize the diarrhea that is associated with bowel radiation, the patient should avoid foods high in roughage, such as fruits and whole grains. Lactose intolerance may develop secondary to radiation, so dairy products should also be avoided.

The nurse teaches a patient with liver cancer about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? A. Lime sherbet B. Blueberry yogurt C. Fresh strawberries D. Cream cheese bagel

B Yogurt has high biologic value because of the protein and fat content. Fruit salad does not have high amounts of protein or fat. Lime sherbet is lower in fat and protein than yogurt. Cream cheese is low in protein.

A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have spread to local lymph nodes. A nurse realizes this cancer would be documented as stage: A. 1. B. 2. C. 3. D. 4.

C Stage 1: cancer confined to the organ of origin Stage 2: Cancer that is locally invasive Stage 3: Cancer has spread to regional structures such as lymph nodes Stage 4: Cancer has spread to distant sites such as liver cancer spreading to a lung or prostate cancer spreading to bone

A primary care provider is attempting to diagnose cancer and is looking for a tumor marker. Which of the following could be a possible marker? A. Red blood cells B. Apoptotic cells C. Enzymes D. Neurotransmitters

C Tumor markers include hormones, enzymes, genes, antigens, and antibodies

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? A. Remove food debris from the teeth and oral mucosa with a stiff toothbrush. B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. D. Rinse the mouth before and after each meal and at bedtime with a saline solution.

D

An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider? A. Patient reports having severe fatigue. B. Patient voids every hour during the day. C. Patient takes only 50% of meals and refuses snacks. D. Patient has crackles up to the midline posterior chest.

D

The most important environmental risk factor for cancer is exposure to: A. ultraviolet (UV) radiation. B. radon. C. estrogen. D. cigarette smoke.

D

The nurse is caring for a patient who received a recent bone marrow transplant. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation? A. Mucositis B. Confusion C. Depression D. Mild temperature elevation

D

When an oncologist is discussing the degree to which an organism's development is contingent on its environment, which of the following is the oncologist explaining? A. Transgenerational inheritance B. Epigenetics C. Histone modification D. Developmental plasticity

D

Which information should the nurse include when teaching about angiogenic factors? In cancer, angiogenic factors stimulate: A. release of growth factors. B. tumor regression. C. apoptosis. D. new blood vessel growth.

D

Which of the following patients would be at greatest risk for basal cell carcinoma? A. Dark complexion, light eyes, underweight B. Light complexion, dark eyes, overweight C. Medium complexion, light eyes, smoker D. Light complexion, light eyes, fair hair

D

While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer? A. Being a woman B. Family history of hypertension C. Cigarette smoking as a teenager D. Advancing age

D

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care? A. Minimize activity until the treatment is completed. B. Establish time to take a short walk almost every day. C. Consult with a psychiatrist for treatment of depression. D. Arrange for delivery of a hospital bed to the patient's home.

B

While planning care for a patient experiencing fatigue due to chemotherapy, which of the following is the most appropriate nursing intervention? A. Prioritization and administration of nursing care throughout the day B. Completing all nursing care in the morning so the patient can rest the remainder of the day C. Completing all nursing care in the evening when the patient is more rested D. Limiting visitors, thus promoting the maximal amount of hours for sleep

A

A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? A. "The cancer involves only the cervix." B. "The cancer cells look like normal cells." C. "Further testing is needed to determine the spread of the cancer." D. "It is difficult to determine the original site of the cervical cancer."

A Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread.

A 50-year-old female confirms chronic alcohol intake. This practice places the patient at risk for cancer in which organs? (Select all that apply.) A. Larynx B. Esophagus C. Liver D. Lung E. Brain F. Breast

A, B, C, F

The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk? (Select all that apply.) A. Pap testing B. Tobacco use C. Sunscreen use D. Mammography E. Colorectal screening

A, C, D, E

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan? (Select all that apply.) A. Cook food thoroughly before eating. B. Choose low fiber, low residue foods. C. Avoid public transportation such as buses. D. Use rectal suppositories if needed for constipation. E. Talk to the oncologist before having any dental work.

A, C, E

Which health promotion information should the nurse include when teaching a patient with a 42 pack-year history of cigarette smoking? (Select all that apply.) A. Resources for support in smoking cessation B. Reasons for annual sputum cytology testing C. Erlotinib (Tarceva) therapy to prevent tumor risk D. Computed tomography (CT) screening for cancer E. Importance of obtaining a yearly influenza vaccination

A, D, E

A water test recently revealed arsenic levels above 200 mcg/L. Which of the following cancers would be most likely to develop in those who consistently drank the water? A. Liver B. Skin C. Colon D. Kidney

B

A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. What should the nurse teach the patient about the outcome of this procedure? A. Pain will be relieved by cutting sensory nerves in the stomach. B. Decreasing the tumor size will improve the effects of other therapy. C. Relieving the pressure in the stomach will promote optimal nutrition. D. Tumor growth will be controlled by removing all the cancerous tissue.

B

Which information indicates a nurse understands characteristics of malignant tumors? A. Grows slowly. B. Has a well-defined capsule. C. Cells vary in size and shape. D. Is well differentiated.

C

A widowed mother of 4 school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate? A. "Don't you have any friends that will raise the children for you?" B. "Would you like to talk about options for the care of your children?" C. "For now you need to concentrate on getting well and not worrying about your children." D. "Many patients with cancer live for a long time, so there is time to plan for your children."

B

An hour after a left thoracotomy, a patient reports incisional pain at a level 7 (based on 0 to 10 scale) and has decreased left-sided breath sounds. The pleural drainage system has 100 mL of bloody drainage and a large air leak. Which action should the nurse take? A. Clamp the chest tube in two places. B. Administer the prescribed morphine. C. Milk the chest tube to remove any clots. D. Assist the patient with incentive spirometry.

B

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? A. "I have frequent muscle aches and pains." B. "I rarely have the energy to get out of bed." C. "I experience chills after I inject the interferon." D. "I take acetaminophen (Tylenol) every 4 hours."

B

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? A. The UAP flushes the toilet once after emptying the patient's bedpan. B. The UAP stands by the patient's bed for 30 minutes talking with the patient. C. The UAP places the patient's bedding in the laundry container in the hallway. D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

B

What topic should the nurse plan to discuss with a patient who has been diagnosed with stage 0 cervical cancer? A. Radiation B. Conization C. Chemotherapy D. Radical hysterectomy

B

A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband tells the nurse that he does not know what to say to his wife. Which problem is appropriate for the nurse to address in the plan of care? A. Anxiety B. Death anxiety C. Difficulty coping D. Lack of knowledge

C

Which statement indicates the patient has a correct understanding of metastasis? The most common route of metastasis is through the blood vessels and: A. lung tissue. B. body cavities. C. lymphatics. D. connective tissues.

C

A patient who has severe pain with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching about pain management has been effective? A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale). B. The patient agrees to take the medications by the IV route to improve analgesic effectiveness. C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs. D. The patient states that nonopioid analgesics may be used if the maximal dose of the opioid is reached without adequate pain relief.

C

A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is accurate? A. "Benign tumors do not cause damage to other tissues." B. "Benign tumors are likely to recur in the same location." C. "Malignant tumors may spread to other tissues or organs." D. "Malignant cells reproduce more rapidly than normal cells."

C

A patient with cancer is eating very little due to altered taste sensation. Which nursing action would address the cause of the patient problem? A. Add protein powder to foods such as casseroles. B. Tell the patient to eat foods that are high in nutrition. C. Avoid giving the patient foods that are strongly disliked. D. Add spices to enhance the flavor of foods that are served.

C

After change-of-shift report, which patient should the nurse assess first? A. A 40-yr-old with a pleural effusion who reports severe stabbing chest pain B. A 72-yr-old with cor pulmonale who has 4+ bilateral edema in his legs and feet C. A 64-yr-old with lung cancer and tracheal deviation after subclavian catheter insertion D. A 28-yr-old with a history of a lung transplant 1 month ago and a fever of 101° F (38.3° C)

C

External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation? A. Test all stools for the presence of blood. B. Maintain a high-residue, high-fiber diet. C. Clean the perianal area carefully after every bowel movement. D. Inspect the mouth and throat daily for the appearance of thrush.

C

The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first? A. A 35-yr-old patient who has wet desquamation associated with abdominal radiation B. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer C. A 24-yr-old patient who received neck radiation and has blood oozing from the neck D. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation

C

After change-of-shift report on the oncology unit, which patient should the nurse assess first? A. Patient who has a platelet count of 82,000/μL after chemotherapy. B. Patient who has xerostomia after receiving head and neck radiation. C. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C). D. Patient who is worried about getting the prescribed long-acting opioid on time.

C Fever is an emergency in neutropenic patients because of the risk for rapid progression to severe infections and sepsis. The other patients also require assessments or interventions but do not need to be assessed as urgently. Patients with thrombocytopenia do not have spontaneous bleeding until the platelets are 20,000/μL. Xerostomia does not require immediate intervention. Although breakthrough pain needs to be addressed rapidly, the patient does not appear to have breakthrough pain.